According to the study, one in four hospital births in Kiambu and Nairobi counties is by C-section followed by Kirinyaga and Embu counties, where a fifth of deliveries are through surgery.

Nyeri and Machakos counties rounded off the list of top five hospitals with 18% while less than 2% of women in Tana River, Wajir, Narok and Mandera underwent surgery.

“In Kenya, there are urban settings where we are doing too many C-sections, yet in the rural areas we don’t have enough to save women’s lives,” said Marleen Temmerman, professor of obstetrics and gynaecology at Aga Khan University.